A meta-analysis of all randomized controlled trials assessing 2 or more treatment modalities for symptomatic hemorrhoids was performed. The main outcome measures were response to therapy, need for further therapy, complications, and pain. Twenty-three trials were available for analysis. Hemorrhoidectomy was found to be significantly more effective than manual dilatation of the anus ( P = .0017) and associated with less need for further therapy ( P = .034), with no significant difference in complications ( P = .60) but more pain ( P P = .001), although complications were greater ( P = .02), as was pain ( P Copyright © 2002 by W.B. Saunders Company
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MacRae et al. (2002) studied this question.